Asymptomatic Tuberculosis: The Silent Face of the Disease Among Migrants and Refugees and the Challenges in Brazil

Historically, tuberculosis has been conceptualized in a binary manner as either tuberculosis infection or tuberculosis disease. However, emerging evidence supports the existence of a tuberculosis spectrum, which necessitates rethinking systematic screening approaches for early diagnosis. These spectrums include tuberculosis infection, incipient tuberculosis, and asymptomatic tuberculosis, all of which may precede the progression to tuberculosis symptomatic disease. Therefore, asymptomatic tuberculosis appears to be an important challenge to disease elimination, particularly among migrants and refugees, demanding early diagnosis and treatment to interrupt community transmission and prevent avoidable deaths. It may be important to consider adopting an active screening strategy that is sensitive to asymptomatic individuals.